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Insurance Authorization Supervisor
2 months ago
Catholic Health stands as a premier provider of health and human services on Long Island.
Our extensive health system encompasses over 16,000 dedicated employees, six acute care hospitals, three nursing facilities, a home health service, hospice care, and a comprehensive network of physician practices throughout the region.
At Catholic Health, our mission centers on the compassionate treatment and service of our communities.We collaborate effectively to deliver empathetic care and employ evidence-based practices to enhance outcomes for every patient, every time.
Join our team of healthcare professionals and discover why Catholic Health is recognized as a leading workplace on Long Island.Job Details:
The Insurance Authorization Supervisor is responsible for overseeing and coordinating insurance verification, notification, prior authorization, and price transparency initiatives for Catholic Health.
This role involves collaboration with patients, healthcare providers, administrative personnel, and insurance representatives to accurately gather and document patient demographic and insurance details necessary for visit approvals.
The Supervisor should possess a strong technical background in financial clearance and be well-versed in managed care protocols.As the primary authority on daily operations, the Supervisor will focus on managing account escalations and providing subject matter expertise within the department.
The Supervisor will also identify training needs within the department and monitor initiatives aimed at performance improvement.Duties and Responsibilities:
Core Behaviors:
The following behaviors are essential for all leadership roles at Catholic Health:
Collaboration & Teamwork:
Fosters cooperative and collaborative efforts towards shared objectives.
Valuing Diversity:
Appreciates and embraces the unique talents and contributions of all individuals.
Service Orientation:
Demonstrates a commitment to serving and addressing the needs of both internal and external customers.
Achieves Results:
Exhibits a drive to achieve and exceed expectations, continuously seeking improvements and taking responsibility for outcomes.
Organizational Alignment:
Aligns people, processes, and structures with the strategic direction of Catholic Health.
Developing Others:
Recognizes the value of employees' knowledge and skills, providing opportunities for continuous learning and development.
Communication:Practices active listening and effectively communicates messages to achieve desired outcomes.
Integrity:Conducts business with honesty and ethical standards, striving for results that benefit the organization while modeling ethical behavior.
Role-Specific Behaviors:
Additional behaviors necessary for this role include:
Relationship Building: Develops and maintains professional relationships across various levels within the organization.
Motivation: Inspires and mentors staff to achieve high levels of expertise and productivity.
Problem Solving: Analyzes complex issues and systematically develops effective solutions.
Essential Skills, Knowledge, and Abilities:
Comprehensive understanding of insurance pre-certification requirements, contract benefits, and medical terminology is essential.
Expertise in insurance, managed care, and federal/state coverage is required.
Must possess strong interpersonal skills and maintain professionalism in interactions with patients, families, and colleagues.
Ability to discuss and finalize financial arrangements under pressure while ensuring positive patient relations is crucial.
Work requires the capacity to interpret and implement policies and procedures.Must uphold patient confidentiality and the integrity of hospital documents.
Demonstrates a positive demeanor and professional appearance.Ability to manage stressful situations and multitask effectively is necessary.
Willingness to complete additional job-related training as required.
Language Ability:
High proficiency required.
Mathematical Ability:
Intermediate proficiency required.
Reasoning Ability:
Very high proficiency required.
Computer Skills:
High proficiency required.
Leadership:
Supervises financial clearance functions and serves as a trusted advisor on insurance eligibility, benefits, prior authorization, and price transparency.
Supports staff development through ongoing coaching, training, and mentorship.
Provides management with actionable insights on process improvement opportunities and oversees the implementation of initiatives aimed at enhancing departmental performance.
Demonstrates exceptional technical skills, efficiency, and quality within the department while collaborating with staff to foster improvement.
Oversees the efforts of staff conducting insurance verification and authorization in accordance with Catholic Health policies.Coordinates staff evaluations, retention, training, and policy management.
Utilizes analytical and problem-solving skills to determine optimal strategies for financial clearance.
Anticipates and mitigates significant issues or risks.
Facilitates communication and promotes integrated operations across departmental lines within the health system as needed.
Ensures that the operations of assigned services foster effective interdisciplinary teamwork, resulting in high-quality, cost-effective, and coordinated services.
Collaborates with management to develop, implement, and standardize policies, procedures, and workflows related to departmental functions.
Works with management to assess and develop new processes to adapt to changes.Proposes innovative strategies to enhance operational efficiencies.
Stays informed about changes in the healthcare financial landscape and shares relevant information with team members.
Communicates insurance information to staff regarding regulations and processing.
Assumes additional responsibilities in the absence of the Manager.
Responsible for other duties as assigned.
People Management:
Responsible for approving work schedules.
Responsible for training new employees.
Conducts staff performance evaluations and implements corrective actions.
Motivates the team to achieve high levels of customer satisfaction and meet organizational goals for service and financial performance.
Identifies new techniques, programs, tools, and processes that enhance communication and support employee engagement and retention.Process Management:
Meets with staff to ensure that all business operations are conducted timely, accurately, and effectively to maximize performance.Ensures that staff informs patients of their financial obligations and appropriately refers them to financial counseling.
Ensures that all accounts are managed within established timeframes.
Educates staff on prioritizing accounts and validating necessary demographic, clinical, and financial information for timely clearance.
Educates staff on medical necessity protocols and the proper use of NCDs/LCDs.Performance Monitoring:
Conducts annual performance reviews in accordance with established policies.
Communicates monthly performance objectives to staff.
Position Requirements and Qualifications:
Education:
Associate's Degree or equivalent experience required.
Experience:
Minimum of 3-5 years of experience in Revenue Cycle Management or Patient Access Services, including Insurance Verification and Pre-Certification, is preferred.
Salary Range:
USD $67,000 - $87,500.00 /Yr.
This range serves as a good faith estimate, and actual pay will depend on various factors, including qualifications, skills, competencies, and experience.
At Catholic Health, we prioritize a people-first approach.
In addition to the estimated base pay, we offer generous benefits packages, tuition assistance, a defined benefit pension plan, and a culture that fosters professional and educational growth.
